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Qualitative Study on Cardiovascular Disease

Feasibility of using Internet-based technology for the remote management of cardiovascular disease

Principal Investigator: Ken Prkachin Co-investigators: Scott Lear, Joanna Bates, Ellen Balka This study uses both quantitative (literature review) and qualitative (face-to-face interviews) research to help identify the feasibility of and barriers to using the internet to deliver cardiovascular disease management programs remotely. These findings will form a foundation for future studies to deliver cardiovascular disease management programs to rural and remote areas and contribute to the development of an internet-based platform that supports cardiac patient self-management and co-management with primary and secondary care providers throughout British Columbia.

Background

Cardiovascular Disease (CVD) is the leading cause of death in Canada and in British Columbia. Proper treatment and management of this complex and chronic disease requires the collaboration of physicians, nurses, allied health professionals and multiple health services. However, limited access to these services and personnel is a significant and persistent problem in BC, especially for patients living in remote or rural communities. With more and more BC residents living with cardiovascular disease, this problem is only expected to increase over time.

Motivation

Internet-based services for the treatment of cardiovascular disease have been suggested as a potential remedy for the problems posed by distance, access and geographic isolation. Yet, the use of these services for the care or monitoring of patients at a distance is still emerging.

Objectives

To explore how technology (and what specific aspects of technology) could support sustainable self-management, patient and family uptake of technology, and behavioural change;

To identify barriers and facilitators that affect patients’ ability to use the internet for management of their disease;

To explore perceptions of specialists and non-specialists health care providers about areas for improvement in the co-management of patients with CVD;

To explore what elements need to be included in a technology platform to meet the needs of specialists and primary care providers with respect to co-management of patients with CVD.

Methodology

Literature Review The literature review was composed of four main sections: studies, articles, internet-based interventions focused on CVD, and Internet-based interventions focused on telemedicine in academic journals and grey literature. Self-care and post diagnosis of CVD, co-management in CVD management, Internet-based interventions for CVD management, technology uptake, and relevant policies were also explored. Structured Face-to-Face Interviews A total of 48 structured, open-ended interviews were recorded and transcribed. Interviews were conducted with physicians, allied health professionals and patients from the Northern Health Authority and the Vancouver Coastal Health Authority. All participants were involved in the co-management of CVD in some capacity. Interviewees were given a password to log on to a demonstration version of a web-based cardiac rehabilitation program which was created by the BCATPR.